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Modeling of symptom growth trajectories facilitates the understanding of predictors of individual outcomes over time. Although growth mixture modeling (GMM) has been applied to military populations, few studies have incorporated both predeployment and follow\u2010up measurements over an extended time. In this prospective study, 1,087 U.S. Army soldiers with varying military occupational specialties and geographic locations were assessed before and after deployment to the Iraq war zone, with long\u2010term follow\u2010up assessment occurring at least 5 years after return from deployment. The primary outcome variable was the PTSD Checklist\u2013Civilian Version summary score. GMM yielded four latent profiles, characterized as primarily asymptomatic (<jats:italic>n =<\/jats:italic> 194, 17.8%); postdeployment worsening symptoms (<jats:italic>n =<\/jats:italic> 84, 7.7%); mild symptoms (<jats:italic>n =<\/jats:italic> 320, 29.4%); and preexisting, with a chronic postdeployment elevation of symptoms (<jats:italic>n =<\/jats:italic> 489, 45.0%). Regression models comparing the primarily asymptomatic class to the symptomatic classes revealed that chronic symptom classes were associated with higher degrees of stress exposure, less predeployment social support, military reservist or veteran status at the most recent assessment, and poorer predeployment visual memory, <jats:italic>OR<\/jats:italic>s = 0.98\u20132.90. PTSD symptom course varies considerably over time after military deployment and is associated with potentially modifiable biopsychosocial factors that occur early in its course in addition to exposures and military status.<\/jats:p>","DOI":"10.1002\/jts.22964","type":"journal-article","created":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T05:09:01Z","timestamp":1692767341000},"page":"955-967","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Early predictors of chronic posttraumatic stress disorder symptom trajectories in U.S. Army soldiers deployed to the Iraq war zone"],"prefix":"10.1002","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2784-6375","authenticated-orcid":false,"given":"Jennifer J.","family":"Vasterling","sequence":"first","affiliation":[{"name":"National Center for PTSD VA Boston Healthcare System  Boston Massachusetts USA"},{"name":"Department of Psychiatry Boston University Chobanian &amp; 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